section name header

Evidence summaries

Somatostatin Analogues for Pancreatic Surgery

Prophylactic somatostatin analogues used in pancreatic surgery appear to reduce perioperative complications and the incidence of pancreatic fistula but not perioperative mortality. In those undergoing pancreatic surgery for cancer, they appear to shorten hospital stay. Level of evidence: "B"

A Cochrane review [Abstract] 1 included 21 studies with a total of 2 348 subjects. There was no significant difference in the perioperative mortality (RR 0.80; 95% CI 0.56 to 1.16; n = 2210) or the number of people with drug-related adverse effects between the two groups (RR 2.09; 95% CI 0.83 to 5.24; n = 1199). Quality of life was not reported in any of the trials. The overall number of participants with postoperative complications was significantly lower in the somatostatin analogue group (RR 0.70; 95% CI 0.61 to 0.80; n = 1903) but there was no significant difference in the re-operation rate (RR 1.26; 95% CI 0.58 to 2.70; n = 687) or hospital stay (MD -1.29 days; 95% CI -2.60 to 0.03; n = 1314) between the groups. The incidence of pancreatic fistula was lower in the somatostatin analogue group (RR 0.66; 95% CI 0.55 to 0.79; n = 2206). The proportion of these fistulas that were clinically significant was not mentioned in most trials. On inclusion of trials that clearly distinguished clinically significant fistulas, there was no significant difference between the two groups (RR 0.69; 95% CI 0.38 to 1.28; n = 292).

Comment: The quality of evidence is downgraded by study quality (unclear allocation concealment).

    References

    • Gurusamy KS, Koti R, Fusai G et al. Somatostatin analogues for pancreatic surgery. Cochrane Database Syst Rev 2013;(4):CD008370. [PubMed]

Primary/Secondary Keywords